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Free Content The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea-Bissau

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Abstract:

OBJECTIVE: To investigate whether the serum level of soluble urokinase plasminogen activator receptor (suPAR) carries prognostic information in individuals infected with Mycobacterium tuberculosis.

DESIGN: suPAR was measured by ELISA in 262 individuals at the time of enrolment into a cohort based on suspicion of active tuberculosis and in 101 individuals after 8 months of follow-up.

RESULTS: The suPAR levels were elevated in patients with active TB compared to TB-negative individuals (P < 0.001). suPAR levels were highest in patients positive for TB on direct microscopy (n = 84, median suPAR 3.17 ng/ml, P < 0.001), followed by patients negative on direct microscopy but culture positive (n = 35, median suPAR 2.41 ng/ml, P = 0.005) and by patients diagnosed on clinical grounds (n = 63, median suPAR 2.13 ng/ml, P = 0.06) compared to 64 TB-negative individuals (median suPAR 1.73 ng/ml). During the 8-month treatment period, 23 TB cases died. In a multivariate Cox model controlling for HIV status, age, sex, CD4 count and type of TB diagnosis, the mortality increase per ng suPAR was 1.25 (95%CI 1.12–1.40). After treatment, suPAR levels had decreased to the levels of TB-negative individuals.

CONCLUSIONS: suPAR levels are elevated in TB patients and associated with mortality. Furthermore, suPAR may be a potential marker of treatment efficacy.

Keywords: prognostic; soluble urokinase plasminogen activator receptor (; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Clinical Research Unit, Hvidovre Hospital, Hvidovre, Denmark 2: Projecto de Saúde de Bandim, Danish Epidemiology Science Centre, Bissau, Guinea-Bissau; and Department of Infectious Diseases, UMAS, Malmö, Sweden 3: Department of Molecular Pathology and Medicine, DIBIT, San Raffaele Scientific Institute, San Raffaele, Italy 4: Projecto de Saúde de Bandim, Danish Epidemiology Science Centre, Bissau, Guinea-Bissau

Publication date: August 1, 2002

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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